1-Attachment A 2025 McKinney Plan Designs.pdf
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- Attached to
- Stop Loss Insurance
- Solicitation number
- 26-01RFP
- Issued by
- Collin County, Texas
About this file
The document is a comprehensive insurance plan design and rate information packet for the City of McKinney, detailing medical insurance options through Cigna for active employees and retirees. The city offers three medical plan designs: Cigna OAP Care, Cigna OAP Plus, and Cigna HSA OAP, each with varying deductible levels, out-of-pocket maximums, and coinsurance rates. The plans provide coverage for individuals, employees with spouses, employees with children, and full family units, with specific benefits including preventive care, emergency room visits, physician and specialist office visits, in-patient and out-patient hospital services, and prescription drug coverage.
The rate tables show the fully-insured equivalent medical rates for both active employees and retirees from 2022 to 2025, with incremental increases each year. The active employee contributions vary by plan tier and coverage level, ranging from as low as $53.20 per month for employee-only coverage in the City Care plan to $296.25 per month for employee and family coverage in the City HSA plan. The stop-loss rates, maintained at a specific deductible of $200,000 with unlimited aggregate maximum, demonstrate the city's approach to managing potential high-cost medical claims. The document also includes detailed breakdowns of specific premiums, aggregate factors, and coverage options, providing a comprehensive view of the city's medical insurance strategy.
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PLAN DESIGNS
CITY OF MCKINNEY
CURRENT MEDICAL PLAN DESIGN – HSA
MEDICAL BENEFITS Cigna
OAP HSA
Deductible Embedded Deductible
In-Network $3,300 Ind. / $6,600 Fam.
Non-Network $6,000 Ind. / $12,000 Fam.
Out Of Pocket Max Includes Deductible, Coins., Copays In-Network $5,500 Ind. / $11,000 Fam.
Non-Network $12,400 Ind. / $24,800 Fam.
Coinsurance In-Network 100% Non-Network 50%
Lifetime Max Unlimited Emergency Room
In-Network $200 Copay after deductible Non-Network $200 Copay after deductible
Maternity Included Physician Office Visit
In-Network Ded. / 0%
Non-Network Ded./ 50% Specialist Office Visit
In-Network Ded. / 0%
Non-Network Ded. / 50% Preventive Care
In-Network Covered at 100% Non-Network Ded./ 50%
Urgent Care In-Network Ded. / 0% Non-Network Ded. / 50%
In-Patient Hospital Per Admission In-Network Ded. / 0% Non-Network Ded. / 50%
Out-Patient Per Admission In-Network Ded. / 0% Non-Network Ded./ 50%
Prescriptions Ded. Then :
Network Retail Pharmacy $10/$30/$60 Mail Order (90 Days) $20/$60/$120 Specialty Drugs $120
Note: This is a brief summary and not intended to be a contract.
CURRENT MEDICAL PLAN DESIGN – OAP
MEDICAL BENEFITS Cigna Care OAP Deductible Embedded Deductible
In-Network $1,500 Ind. / $3,500 Fam.
Non-Network N/A
Out Of Pocket Max Includes Deductible, Coins., Copays In-Network $6,600 Ind. / $13,200 Fam.
Non-Network N/A
Coinsurance In-Network 80% Non-Network N/A
Lifetime Max Unlimited Emergency Room
In-Network $200 Copay + 20% Non-Network $200 Copay + 20%
Maternity Included Physician Office Visit
In-Network Preferred : $10 Tier 1 : $25, Non-Tier 1 $45 Non-Network N/A
Specialist Office Visit In-Network Tier 1 : $40, Non-Tier 1 $60 Non-Network N/A
Preventive Care In-Network Covered at 100% Non-Network N/A
Urgent Care In-Network Preferred : $25, $50 Non-Network $50 Copay
In-Patient Hospital Per Admission In-Network Ded./ 20% Non-Network N/A
Out-Patient Per Admission In-Network Ded./ 20% Non-Network N/A
Prescriptions Network Retail Pharmacy $10/$30/$60 Mail Order (90 Days) $20/$60/$120 Specialty Drugs 10%, not less than $75 or more than $200
CURRENT MEDICAL PLAN DESIGN – OAP PLUS
MEDICAL BENEFITS Cigna Care Plus Deductible Embedded Deductible
In-Network $750 Ind. / $1,500 Fam.
Non-Network N/A
Out Of Pocket Max Includes Deductible, Coins., Copays In-Network $4,400 Ind. / $8,800 Fam.
Non-Network N/A
Coinsurance In-Network 80% Non-Network N/A
Lifetime Max Unlimited Emergency Room
In-Network $200 Copay + 20% Non-Network $200 Copay + 20%
Maternity Included Physician Office Visit
In-Network Preferred : $10 Tier 1 : $25, Non-Tier 1 $45
Non-Network N/A Specialist Office Visit
In-Network Tier 1 : $40, Non-Tier 1 $60
Non-Network N/A Preventive Care
In-Network Covered at 100% Non-Network N/A
Urgent Care In-Network Preferred : $25, $50 Non-Network $50 Copay
In-Patient Hospital Per Admission In-Network Ded./20% Non-Network N/A
Out-Patient Per Admission In-Network Ded./20% Non-Network N/A
Prescriptions Network Retail Pharmacy $10/$30/$60 Mail Order (90 Days) $20/$60/$120 Specialty Drugs 10%, not less than $75 or more than $200
City of McKinney Rate History
Stop Loss Rates
2023 2024 2025 Carrier Name Cigna Cigna Cigna Plan OAP OAP OAP Specific Stop Loss Deductible $200,000 $200,000 $200,000
Aggregate Maximum Unlimited Unlimited Unlimited
Specific Contract PAID (M, Rx) PAID (M, Rx) PAID (M, Rx)
Specific Covers Medical & Rx Medical & Rx Medical & Rx
Maximum Reimbursement Unlimited Unlimited Unlimited Specific Premium
Composite $162.43 EE
$179.73 EE $221.97 EE
Aggregate Contract PAID (M, Rx) PAID (M, Rx) PAID (M, Rx)
Aggregate Covers Medical & Rx Medical & Rx Medical & Rx
Aggregate Premium Composite $5.75 $6.09 $6.19
Aggregate Factors
Composite
HSA: $1,700.16
OAP: $1, 818.44
OAP Plus: $1,473.08
HSA: $1,557.48
OAP: $1, 798.31
OAP Plus: $1,924.22
HSA: $1,658.08
OAP: $1,914.88
OAP Plus: $2,049.16 Lasers or Other None None None
RATES
Active Employee Fully-Insured Equivalent Medical Rates
Retiree Fully-Insured Equivalent Medical Rates
2022 2023 2024 2025 Cigna OAP Care Plan
Employee Only $708.14 $719.53 $746.56 $763.48 Employee + Spouse $1,583.56 $1,609.03 $1,669.47 $1,707.31 Employee + Children $1,407.04 $1,429.67 $1,483.37 $1,516.99 Employee + Family $2,358.41 $2,396.34 $2,486.35 $2,542.70
Cigna OAP Plus Plan Employee Only $782.03 $794.61 $824.46 $843.15 Employee + Spouse $1,754.95 $1,783.18 $1,850.16 $1,892.09 Employee + Children $1,558.93 $1,584.00 $1,643.30 $1,680.75 Employee + Family $2,614.98 $2,647.04 $2,746.47 $2,808.72
Cigna HSA OAP Plan Employee Only $673.24 $684.07 $709.76 $725.85 Employee + Spouse $1,506.59 $1,530.82 $1,588.32 $1,624.32 Employee + Children $1,338.28 $1,359.80 $1,410.88 $1,442.86 Employee + Family $2,243.46 $2,279.54 $2,365.16 $2,418.77
2022 2023 2024 2025 Cigna OAP Care Plan
Retiree Only $779.00 $809.00 $857.54 $857.54 Retiree + Spouse $1,618.00 $1,680.00 $1,780.80 $1,801.37 Retiree + Children $1,430.00 $1,485.00 $1,574.10 $1,611.05 Retiree+ Family $2,129.00 $2,211.00 $2,343.66 $2,636.76
Cigna OAP Plus Plan Retiree Only $860.00 $893.00 $946.58 $946.58 Retiree + Spouse $1,903.00 $1,976.00 $2,094.56 $2,094.56 Retiree + Children $1,669.00 $1,733.00 $1,836.98 $1,836.98 Retiree + Family $2,486.00 $2,582.00 $2,736.92 $2,636.76
Cigna HSA OAP Plan Retiree Only $642.00 $667.00 $707.02 $725.85 Retiree + Spouse $1,463.00 $1,519.00 $1,610.14 $1,628.97 Retiree + Children $1,278.00 $1,327.00 $1,406.62 $1,442.86 Retiree + Family $2,275.00 $2,363.00 $2,504.78 $2,523.61
CITY OF MCKINNEY ACTIVE CONTRIBUTIONS
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